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Supplemental oxygen: ensuring its safe delivery during facial surgery
R J Reyes1, A A Smith, J R Mascaro
1Division of Plastic and Reconstructive Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Plastic and Reconstructive Surgery
|April 1, 1995
Summary
Supplemental oxygen during facial surgery poses a fire risk when using electrosurgical coagulation. Adapted oxygen delivery systems are hazardous and can ignite, unlike properly placed nasal cannulas.
Area of Science:
- Plastic Surgery
- Biomedical Engineering
- Fire Safety
Background:
- Electrosurgical coagulation is frequently used in facial surgery.
- Supplemental oxygen delivery is common in surgical settings.
- The combination of electrosurgery and oxygen presents a potential fire hazard.
Observation:
- A case of flash fire and facial burns occurred during surgery with blow-by oxygen and electrosurgery.
- A fiberglass facial model was used to investigate fire risks.
- Variables studied included oxygen flow, delivery systems, distance, and electrosurgical power.
Findings:
- Adapted suction tubing and displaced nasal cannulas ignited under specific conditions (30 W, 2 L/min O2, 5 cm distance).
- A properly placed nasal cannula did not ignite, regardless of tested parameters.
- The risk of ignition is dependent on oxygen delivery method, flow rate, and proximity to the electrosurgical device.
Implications:
- Facial surgery using electrosurgical coagulation with supplemental oxygen requires extreme caution.
- Adapted oxygen delivery systems are unsafe for this application.
- Further research is needed to develop and validate safe oxygen delivery methods for use with electrosurgery.